Malangizo 4 Omwe Mungapangitse Kuti Mankhwala Anu a Edzi Akhale Opindulitsa

Mtengo Wapamwamba wa Kusamala Ukufuna Njira Yogula Yodziwika

Kupereka chithandizo chamagetsi chapamwamba kwa anthu ambiri a ku America ndi ovuta popanda vuto lina la matenda aakulu. Mwachidziwikire, kwa anthu omwe ali ndi kachilombo koyambitsa matenda a Edzi, mavutowa ndi opambana chifukwa cha mtengo wapatali wa mankhwala osokoneza bongo, kufunika kokwanira kulandira mankhwala , komanso kufunika kwa nthawi zonse, chithandizo chamankhwala chamoyo wonse ndi chisamaliro.

Mwachitsanzo, taganizirani kuti, pafupifupi ndalama zonse za moyo wa HIV zoposa $ 400,000-ndipo izi ndizo kwa anthu amene ayamba kumwa mankhwala mofulumira makamaka kupeŵa matenda omwe amayamba nawo.

Tsopano onjezerani kutero mtengo wa kachilombo ka HIV, womwe umakhala ndi mtengo wochuluka wa $ 2,000 pamwezi, ndipo zovuta zimakula bwino. Ngakhalenso ndi mankhwala osokoneza bongo, ambiri mwa mankhwalawa amakhalabe osokonezeka chifukwa cha "zovuta" zomwe inshuwalansi zingafune kuti pakhale paliponse 20 peresenti mpaka 50 peresenti ya malipiro olimbitsa thupi .

Izi zikutanthauza kuti munthu yemwe ali ndi "zochepa" 20 peresenti amapindula mosavuta pakati pa $ 440 mpaka $ 480 pa mwezi kuti apeze Triumeq , mwachindunji , njira imodzi ya mapiritsi. Ndipo izo sizikuwerengera nkomwe mtengo wa zopatsa ndalama ndi ndalama zina zomwe sizingatheke kuwonjezera pa madola zikwi zambiri musanapindule nazo.

Ngakhale kuti zikhoza kukhala zovuta makamaka makamaka kwa opeza malipiro omwe sangathe kulipira ngongole kapena zopindula zomwe zimapereka magulu a ndalama zochepa-pali mankhwala.

Ena angafune kuti musinthe ndondomeko yanu ya inshuwalansi, pamene ena angakuloleni kuti mupeze mapulogalamu omwe mungakhale mukuganiza kuti simukuyenera.

Kwa iwo ofuna chithandizo, apa pali njira zinayi zochepetsera mtengo wapatali wa chithandizo cha HIV ndi chisamaliro.

1. Yambani Podziwa Kuyenera Kwanu Kuthandizira

Malingaliro olakwika ambiri ndi akuti mapulogalamu othandizira kachilombo ka HIV amayenera kuthandiza anthu ochepa kwambiri a ku America.

Ndipo ngakhale ziri zoona kuti mapulogalamu ambiri a federal ndi a boma amalepheretsa kupeza kwa anthu omwe amakhala pansi kapena pansi pa federally prescribed poverty line, sizinali nthawi zonse.

Chifukwa cha mtengo wapatali wa chithandizo ndi chisamaliro cha HIV, phindu lopambana limapezeka kwa anthu omwe pachaka ali ndi ndalama zokwana $ 65,000 kapena mabanja omwe ali ndi ndalama zokwana madola 80,000. Izi zili choncho chifukwa omwe amapatsidwa ndalama zowonjezera ndizochepa kuposa 200 peresenti mpaka 500 peresenti ya federal poverty level (kapena FPL).

Kufotokozera, ndalama zowonongeka chaka chilichonse (kapena MAGI) si ndalama zonse zomwe inu ndi mnzanu mumapanga patapita chaka. M'malo mwake ndi ndalama zowonongeka (AGI) zomwe zimapezeka pa kubwerera kwa msonkho kwa chaka ndi chaka (mzere 37 pa 1040, mzere 21 pa 1040A, ndi mzere 4 pa 1040EZ) kuphatikizapo zowonjezera:

• Zopanda msonkho Zopindulitsa za Social Security (mzere 20a wochezera mzere 20b pa 1040)
• Chiwongoladzanja chopanda msonkho (mzere 8b pa 1040)
• Sankhani (mzere 45 ndi 50 kuchokera ku IRS mawonekedwe 2555)

Pogwiritsa ntchito chiwerengerochi, mungathe kuwerengera MAGI yanu ndi kuwona ngati ikugwa pansi pa FPL chilolezo chokhazikitsidwa ndi pulogalamu inayake ya federal, boma, kapena yapadera.

Ingowonjezerani MAGI yanu mwadongosolo (mwachitsanzo, osachepera 300 peresenti ya FPL) kuti muwone ngati mukuyenerera.

Pulezidenti wa umphaŵi (FPL) , panthawiyi, ndi chiwerengero cha bungwe la US Health and Human Services (DHHS) kuti aone ngati munthu kapena banja ali oyenerera thandizo la federal monga Medicaid . Mu 2016, DHHS inapereka malangizo otsatirawa a FPL kwa anthu ndi mabanja:

• $ 11,880 payekha
• $ 16,020 kwa banja lachiwiri
• $ 20,160 kwa banja la 3
• $ 24,300 kwa banja la 4
• $ 28,440 kwa banja la 5
• $ 32,580 kwa banja la 6
• $ 36,730 kwa banja la 7
• $ 40,890 kwa banja la 8

(The FPL kwa Alaska ndi Hawaii ndi apamwamba kwambiri.)

Pogwiritsa ntchito malangizowa, munthu amene MAGI wosakwana 138 peresenti ya FPL akhoza kulandira Medicaid pogwiritsa ntchito ndalama zokha. Mofananamo, thandizo lingakhalepo kwa amene MAGI ali ndi 200% kapena kuposa 500 peresenti ya FPL. Ndi nthawi yayitali yomwe ingapindulitse mabanja apamwamba kwambiri omwe ali ndi HIV.

Kodi mumapempha mkulu bwanji?

Pogwiritsa ntchito mawu olemera a dollar, banja lodzigwira ntchito ku Massachusetts lolemba limodzi ndi ndalama zambiri pachaka za inshuwalansi ya $ 90,000 ndi inshuwalansi yaumwini payekha zingathe kukhala ndi MAGI pafupifupi $ 76,000. Ku Massachusetts, kupeza mwayi wothandizira pulogalamu ya ma ARV (HDAP) kumabanja omwe ali ndi MAGI oposa 500 peresenti ya FPL (kapena $ 80,100 mu 2016). Muziwerengero izi, banjali likhoza kulandira HDAP.

Mosiyana ndi zimenezi, banja lomwelo likanakhala kuti siloyenera ku Texas malinga ndi momwe boma liyenera kukhazikitsira pa 200% la FPL (kapena $ 32.040 mu 2016). Komabe, mapulogalamu angapo omwe amalandira ndalama ( onani m'munsimu ) angakhalepo omwe ali ndi mabakiteriya apamwamba.

2. Yambani Njira Yabwino Mukasankha Ndondomeko ya Inshuwalansi

Kugwiritsira ntchito ndondomeko yabwino kwambiri kwa inu ndi banja lanu nthawi zambiri kumakhala pamodzi kuphatikizapo kujambula kosayenera. Ngati ndinu munthu amene ali ndi kachilombo ka HIV, mumatha kuwerengera ndalama zanu za pachaka kuphatikizapo ndalama zanu za pachaka komanso ndalama zomwe mumagwiritsa ntchito patsiku. Osavuta okwanira equation, zikuwoneka.

Kapena kodi?

Chifukwa cha mtengo wapatali wa mankhwala osokoneza bongo, si zachilendo kupeza nokha kupereka malipiro amodzi-kapena osachepera pamwezi pamodzi mosasamala kanthu kuti mumalandira ndalama zapamwamba / zochepa zomwe zimaperekedwa / ndalama zochepa zothandizira ndalama kapena zapamwamba / zotsika kwambiri ndondomeko yamalipiro.

Ichi ndi chifukwa chakuti mankhwala omwe ali ndi kachilombo ka HIV nthawi zonse amaikidwa pamtengo wapadera wotengera "mankhwala" ngati muli ndi ndondomeko yotsika mtengo. Ndipo, ngakhale ngati sichoncho, ndalama zanu za pachaka zimakhala zotsika kwambiri kuti mutha kugwiritsira ntchito ndalama zambiri musanalandire phindu lililonse.

Koma sizinali nthawi zonse. Pano pali mfundo zingapo zophweka posankha inshuwalansi yabwino ngati muli ndi kachirombo ka HIV:

• Musapewe ndondomeko zowonjezereka za mankhwala osokoneza bongo. Nthaŵi zambiri timakonzekera kuti kuchepetsa ndalama zomwe timapereka kuti tipewe ndondomeko zomwe zili ndi ndalama zothandizira mankhwala kulikonse kuyambira 20 peresenti mpaka 50 peresenti. Ndipo izo zingakhale zolakwitsa. M'malo mwake, kumbukirani kuti nthawi zonse muyang'ane zowonjezera zomwe zalembedwa pa ndondomeko. Nthaŵi zina, denga likhoza kukhala lotsika kwambiri (mwachitsanzo, $ 2,000 / $ 1,000) kuti mukwaniritse malire anu apakati pa mwezi umodzi kapena awiri. Pambuyo pake, 100 peresenti ya ndalama zonse zothandizira zaumoyo zidzakonzedwe ndi kampani yanu ya inshuwalansi, kuphatikizapo mankhwala onse, ma test lab, madokotala, komanso maulendo opatsirana.
  
• Fufuzani kuti muwone ngati pali mankhwala ochotsera mankhwala. Ngakhale ambirife timamvetsa kuti deductible ndi yotani, ena sangadziwe kuti nthawi zina zimadulidwa pokhazikitsa lamulo limodzi. Zikatero, mankhwala osokoneza bongo amachokera nthawi zonse pang'onopang'ono kwambiri, kutanthauza kuti mungathe kupeza mankhwala omwe mumakhala nawo kale kusiyana ndi mankhwala osakaniza. Izi ndizothandiza makamaka ngati mankhwala anu a kachilombo ka HIV ali pamunsi pa ogulitsa mankhwala osokoneza bongo.
  
• Onetsetsani mankhwalawa chifukwa cha ndalama zomwe mungasunge. Mankhwalawa amaperekedwa chaka chilichonse ndi makampani a inshuwalansi kuti adziwe kuti ndi mankhwala ati omwe amagwera pansi . Ndipo zimasiyana kwambiri kuchokera kwa inshuwaransi mpaka lotsatira. Nthawi zina, mapiritsi ophatikizidwa akhoza kulembedwa pamtunda wapamwamba, pamene mankhwala ake akugwiritsidwa ntchito pazomwe zili zochepa kwambiri. Izi zikhoza kukuthandizani kuti mupeze ngati mankhwala awiriwa, mtengo, osagwiritsa ntchito mapiritsi amodzi-makamaka ngati mankhwala osokoneza bongo amafunika kupirira komanso mapiritsi amodzi amangofuna kubwezera . Pafupifupi nthawi zonse, ndalama zothandizira ndalama ndizofunika mtengo pokhudzana ndi mankhwala osokoneza bongo.
  
• Ganizirani inshuwalansi yapayekha pa ntchito yogwiritsa ntchito ntchito. Nzeru yowonjezereka imatha kunena kuti inshuwalansi yothandizira ("gulu") yothandiza inshuwalansi nthawi zonse ndi yabwino, zomwe zimakhala ndi ndalama zothandizira anthu kuti azigwiritsa ntchito ndalama zambiri pamwezi. Ndipo ngakhale ziri zoona kuti kawirikawiri ntchito ya premium pa ndondomeko ya gulu ndi 143 peresenti yochepa kusiyana ndi dongosolo la munthu, kuchepetsa ndalama zambiri zimatanthawuzira kuwononga ndalama zambiri, makamaka kwa anthu omwe ali ndi HIV. Kodi masewera musanachite ndondomeko iliyonse ndipo ganizirani kusankha ngati gulu silikukwaniritsa zosowa zanu ndi bajeti yanu.

3. Gwiritsani Ntchito Moyenera Adap Benefits

Gawo lothandizira mankhwala a Edzi (ADAP) lakhala litatengedwa kuti ndilo mzere woyamba wa mankhwala opatsirana kachilombo ka HIV kwa apakati mpaka pakati -waphatikiza a America. Kuyambira pachiyambi cha 1987, kuchuluka kwa pulogalamuyi kwawonjezeka kwambiri, ndi maiko ena tsopano akuphatikizapo chithandizo chamankhwala, mayeso a labu, chithandizo cha inshuwalansi, komanso kachilombo koyambitsa kachilombo ka HIV m'ndondomeko yawo.

Monga momwe zilili ndi mapulogalamu ena omwe amapereka ndalama zogwirizana ndi ndalama, kuyenerera kumadalira makamaka za ndalama, zomwe zingakhale zosiyana kwambiri ndi boma ndi boma. Umboni wokhalamo ndi zolemba za HIV zimayenera.

Ngakhale kuti mayiko ambiri amalephera kulandira anthu okhala ku US komanso anthu olemba mbiri okha, ena monga Massachusetts ndi New Mexico tsopano akuwonjezera thandizo la ADAP kwa othawa kwawo osatumizidwa, komanso.

Pakalipano, maiko asanu ndi limodzi a ku America amalepheretsa anthu kapena mabanja omwe ali ndi chiwongoladzanja chogwera pansi pamtunda, kuyambira pa $ 25,000 ku New York State kukapitirira madola 4,500 ku Georgia.

Zomwe zilipo tsopano za ADAP zogwiritsidwa ntchito zimayikidwa motere:

• Oposa 200% a FPL: Arkansas, Iowa, Nebraska, Oklahoma, Puerto Rico, Texas
• Oposa 250% a FPL: Alabama
• Oposa 300% a FPL: Georgia, Illinois, Indiana, Kansas, Louisiana, Missouri, Mississippi, North Carolina, Ohio, South Carolina, South Dakota, Wisconsin
• FPL oposa 400%: Alaska, Arizona, Colorado, Connecticut, Florida, Hawaii, Minnesota, Nevada, New Hampshire, North Dakota, Rhode Island, Tennessee, Virginia, Washington, West Virginia
• Pansi pa 431% ya FPL: Montana
• Pansi pa 435% ya FPL: New York
• Oposa 450% a FPL: Michigan
• FPL zosakwana 500%: California, District of Columbia, Kentucky, Maine, Maryland, Massachusetts, New Jersey, Oregon, Pennsylvania, Vermont
• Malinga ndi ndalama za pachaka: Delaware (zosakwana $ 50,000), Wisconsin (yosiyana ndi dera)

ADAP imayesedwa ngati malipiro omaliza, kutanthauza kuti, pokhapokha mutapatsidwa mwayi wothandizira Medicaid kapena Medicare, muyenera kulembetsa mtundu wina wa bungwe la inshuwalansi. (Ochepa chabe amapereka chithandizo chothandizidwa kwa iwo amene sangathe kulipira ndi / kapena osayenera ku Medicaid.)

Musanadzipereke kwa inshuwalansi iliyonse, funsani munthu wothandizira ADAP wanu kuti awone ngati mukuyenerera thandizo. Malinga ndi mtundu wa phindu limene mungathe kulipeza, mungathe kusankha chithandizo cha inshuwalansi choyenera kufunikira kwa wina aliyense.

Ngati, mwachitsanzo, mtengo wa mankhwala ndizopindulitsa kwambiri ndipo simukuwoneratu kuti mukugwiritsa ntchito ndalama zowonjezera chaka chilichonse, mukhoza kusankha inshuwalansi pamtengo wapatali pamwezi uliwonse komanso phindu lopanda ndalama zowonjezereka. thumba lalikulu. Mwanjira iyi, mungayambe kulipira mayeso anu a magazi awiri pachaka ndi maulendo a dokotala, palibe china chirichonse.

Komabe, ngati muli ndi zinthu zina zomwe zilipo kale kapena mukuwoneratu ndalama zakuchipatala za chaka chino, mungafunike ndondomeko yomwe imapereka ndalama zochepa zochepa kapena zochepa. Pankhaniyi, ADAP ikhoza kuthetsa kwambiri mtengo wapatali wa chithandizo ndipo mwina, nthawi zina, amapereka mwayi wa mankhwala omwe amachiza matenda okhudzana ndi HIV.

Choyamba ndi ichi: ntchito ndi oimira ADAP wanu ndikumufotokozera zambiri zokhudza phindu lanu komanso mankhwala omwe akupezekapo. Mwa njira iyi, mukhoza kupanga chisankho chodziwika bwino chomwe chimayendera bajeti yanuyo komanso zosowa zanu zaumoyo.

4. Tengani Zopindulitsa Zambiri Zothandizira Mankhwala Osokoneza Bongo

Pokhudzana ndi kuchepetsa ndalama zowonongeka za mankhwala osokoneza bongo, timakonda kuganizira kwambiri za mapulogalamu a boma / boma ndikuiwala kuti thandizo likupezeka mosavuta kupyolera mwa opanga mankhwala akuluakulu onse a HIV. Izi zimaperekedwa ngati chithandizo cha inshuwalansi kapena ndalama zothandizira odwala (PAPs).

Kuthandizira kulipira (HIV) kulipira kwa anthu omwe ali paokha ndipo amapereka ndalama kulikonse kwa $ 200 pamwezi kuti athandizidwe mosalekeza pambuyo polipira ndalama zokwana $ 5 (monga mankhwala a Edurant, Intelence, ndi Prezista).

Ntchitoyi ndi yosavuta, ndipo nthawi zambiri palibe malire okhudzana ndi ndalama. Izi zingakhale zopindulitsa kwambiri kwa ogulitsa inshuwalansi yatsopano, kuwalola kuti asankhe mankhwala otsika mtengo omwe ndalama zawo zothandizira ndalama kapena ndalama zoyendetsera ndalama zikugwera pansi pa zomwe amapatsidwa pachaka / mwezi uliwonse.

Tiyeni titi, mwachitsanzo, muli pa Triumeq mankhwala, omwe opanga amapereka phindu la pachaka la $ 6,000 pachaka. Ngati Triumeq ikuyikidwa pa mankhwala osokoneza bongo omwe amafunika kubweza ngongoleyo, zambiri zimapindula mokwanira kuti zigwirizane ndi ndalama zonse.

Koma, kodi mungachite chiyani ngati Triumeq ikugwera pakati pa magawo 20, 30 peresenti, kapena 50 peresenti? Zikatero, mungathe kupeza ndondomeko yokhala ndi otsika kwambiri. Mutha kugwiritsa ntchito ndalama zothandizira ndalama kuti muthe kulipira mankhwala onse mpaka nthawi yomwe mumatha kufika chaka chonse, ndipo ndalama zonse-madokotala, maulendo a X-ray, maulendo oyendera dokotala-amapezedwa 100 peresenti ndi inshuwalansi yanu.

Njira ina ndi ndondomeko zothandizira odwala HIV (PAPs) . Mapepala apangidwa kuti apereke mankhwala aulere kwa anthu osalimbikitsidwa omwe sali oyenera ku Medicaid, Medicare, kapena ADAP. Kuyenerera nthawi zambiri kumangokhala kwa munthu kapena mabanja omwe ndalama zomwe adapeza chaka chathachi chinali 500 peresenti pansi pa FPL (ngakhale kuti pokhapokha angapangidwe chifukwa cha odwala Medicare Part D kapena anthu omwe sali ovomerezeka omwe ndalama zawo zothandizira zaumoyo sizikhala zovuta).

PAP nthawi zambiri zimakhala zopulumutsa moyo kwa anthu okhala m'mayiko monga Texas, komwe Medicaid ndi ADAP zimangokhala kwa anthu ochepa kwambiri omwe amapeza ndalama (ie, 200 peresenti pansi pa FPL). Masiku ano, ambiri a PAP amapezeka kwa anthu 500 peresenti pansi pa FPL, popanda malire ovomerezedwa ndi ukonde.

Komanso, ngati kusintha kovomerezeka kwa boma kukukhazikitseni mwadzidzidzi kwa ADAP, mukhoza kukhalabe oyenerera thandizo la PAP ngakhale mutakhala kunja kwa ndalama zanu. Kawirikawiri, mapulogalamu a PAP amakhala ovuta kwambiri kuthana nawo powafunsa mofanana ndi maofesi a boma, ndipo nthawi zambiri amatha kukutsogolerani ku mapulogalamu ena omwe si a boma omwe amapereka thandizo la HIV.

Ndipo Choyamba Choyamba

Ngakhale kukwanitsa kuli kofunikira pa chithandizo chamankhwala, musalole kuti mtengo wokha ukhazikitse chithandizo cha mankhwala. Ngakhale kuti mungathe kupulumutsa madola angapo mwadongosolo lapiritsi imodzi (mwachitsanzo, Atripla) pazipangizo zamagulu (Sustiva + Truvada), kusintha koteroko sikuyenera kupangidwa popanda kuwonana mwachindunji ndi dokotala wanu.

Izi ndizowona makamaka ngati mutasintha kusintha ku regimen yomwe chigawo chilichonse cha mankhwala chili chosiyana ndi zomwe mukukhala pano. Kusintha kwa mankhwala osasinthika kungapangitse ngozi ya kusakanizidwa ndi mankhwala osapitirira nthawi , zomwe zimapangitsa kuti kusamalidwa koyambirira kusamalidwe .

Chofunika kwambiri ndi ichi: ndi bwino kufufuza bwino njira zonse zothandizira musanaganizire kusintha kulikonse kwa mankhwala omwe angathe kuwononga thanzi lanu. Kuti mudziwe zambili, funsani ma bungwe a Pulogalamu ya Pulojekiti ya Pulogalamu yovomerezeka (PPA), yomwe imagwirizanitsa odwala ku mapulogalamu othandizira kwaulere, kapena HarborPath, gulu lopanda phindu lomwe lili ku Charlotte, North Carolina lomwe limatulutsa ufulu wa HIV kuti ukhale woyenera , anthu osalimbikitsidwa.

> Zotsatira:

> Farnham, P .; Gopalappa, C .; Dipo, S ..; et al. "Zosintha Zomwe Moyo Wonse Umasamalira ndi Moyo Womwe Umayesa Anthu Omwe ali ndi kachilombo ka HIV ku United States: Kutha Posachedwa Kudziwa Kwambiri ndi Kulowa M'kusamalidwa." Journal of Deficiency Immune Deficiency Syndromes. October 2003; 64: 183-189.

> Kaiser Family Foundation (KFF). "Avereji Yodziwika Kwambiri pa Wogwira Ntchito Yogwira Ntchito Kwa Inshuwalansi Yogwira Ntchito Yogwira Ntchito - 2015." Oakland, California; inapezeka pa December 8, 2016.

> KFF. "Avereji ya mwezi uliwonse Pulezidenti Aliyense payekha." 2013; inapezeka pa December 8, 2016.